The available carbohydrates of any food, namely sugars, dextrins and starch undergo digestion and absorption mainly in the form of glucose in human gastrointestinal tract which subsequently enters the blood stream. In response to glucose assimilation in the blood, the pancreas releases insulin and helps in metabolizing glucose. This results in maintaining proper level of glucose in blood in a specified range. In healthy humans, the insulin response is adequate to maintain blood glucose levels in normal limits but any aberration in the insulin response results in excess (hyperglycemia) or low (hypoglycemia) glucose levels in blood. Prolonged state of hyperglycemia leads to Type II (non-insulin dependent) diabetes, demanding regular intake of hypoglycemic medicines, and if not managed properly, the condition leads to Type I (insulin dependent) diabetes. This physiological disorder also occurs due to the destruction and malfunctioning of pancreatic beta cells or inadequate insulin secretion or secretion of ineffective insulin.
The prevalence of hyperglycemia or Type II diabetes is increasing alarmingly worldwide. In India about 5% of the population in general, and about 8% over 40 years, suffer from Type II diabetes. Diabetes mellitus, a physio-pathological disorder and is rarely curable but is manageable through medicines and diet, backed by regular exercise. However, management of diabetes through diet is very much practical, effective and remunerative. Because many of the complications associated with hyperglycemia such as accelerated ageing, ketoacidosis, atherosclerosis, nephropathy, neuropathy, retinopathy and delayed wound healing could be regulated by proper management of blood sugar. Realizing the important role of dietary management in Type II diabetes, the physicians, dieticians and ‘diabetes care centers’ are paying greater attention towards diets of the diabetics. In this regards, the scientific studies emphasize on foods containing slow digesting or complex carbohydrates, adequacy of dietary fiber, phytochemicals, antioxidants and micro-nutrients which exert blood glucose attenuation or of hypoglycemic properties. Such foods are not only beneficial in regulating the blood glucose response of the Type II diabetes, but also will be useful to healthy population in minimizing the risk of diabetes. The diets rich in complex carbohydrates, moderate levels of fat rich in PUFA, and also containing appropriate levels of essential micro-nutrients reported to be beneficial in regulating the blood glucose response in Type II diabetes for which reference may be made to D. J. A. Jenkins and co-workers (Metabolic effects of a low-glycemic index diet. American Journal of Clinical Nutrition, vol. 46, 968–75, 1987). Reference may also be made to G. Frost and A. Dornhorst (The relevance of the glycemic index to our understanding of dietary carbohydrates. Diabetic Medicine, vol. 17, 336–345, 2000), where in, low glycemic food ingredients are recommended to Type II diabetes, as hypoglycemic foods slowly release the glucose without causing spikes in blood sugar and thus preventing the risk involved with hyperglycemia.
Accordingly, fiber rich cereals such as whole wheat, low polish rice or brown rice, millets, grain legumes and leafy vegetables are suitable dietary components for diabetics (Simin L., Intake of refined carbohydrates and whole grain foods in relation to risk of Type II diabetes mellitus and coronary heart disease. Journal of American College of Nutrition, vol. 21, 298–306, 2002). Madar Z., Abel R., Samish S. and Arad J. (Glucose lowering effect of fenugreek in non-insulin dependent diabetics. European Journal of Clinical Nutrition, vol. 42, 51–54, 1988) reported that fenugreek (Trigonella foenum graecum) in the native form or on processing (germinated, boiled, toasted) exerts beneficial effects in regulating the blood glucose response.
Fenugreek provides twin advantages, namely, it stimulates b-cells to release the insulin response to glucose assimilation in the blood, and serves as a source of soluble dietary fibre mainly in the form of galactomannan, with galactose to mannose in 1:1 ratio, which is highly beneficial with respect to its physiological action in the GI tract. In recent years, the role of micro-nutrients such as chromium, selenium and zinc in acting synergetic to the hypoglycemic foods towards regulating the blood glucose in Type II diabetes has been well recognized (Anderson, et al., Elevated index of supplemental chromium improves glucose and insulin variables in individuals with Type II diabetes. Diabetes, vol. 46, 1786–91, 1997). Incorporation of amla (Phyllanthus emblica) and kokum (Garcinia combogia) as minor components of diets for diabetes, not only provide vitamin C, hydroxyl citric acid (HCA) and dietary fiber, but also phytochemicals with nutraceuticals with hypoglycemic properties (Clouatre D. and Rosenbaum M. The diet and health benefits of HCA. Keats Publishing, Inc. Connecticut, 1994). On the other hand incorporation of spices in proper proportion will contribute the natural antioxidants which also regulate the growth of pathogenic microflora in the gut.
A variety of foods, food supplements, herbal formulations, non-nutritive sweeteners and foods containing artificial sweeteners are marketed as diabetic foods in the country (Table 1) and also abroad. The draw backs of the hitherto known diabetic foods available as proprietary products to the consumers are that, most of them do not provide authentic information about the nature and processing the ingredients have undergone. Moreover, the energy derived from carbohydrates, proteins and fat, from the proprietary diabetic foods very often does not fall in the range normally recommended for the diabetics. Another draw back of the diabetic foods supplements is that, the information on their clinical safety specifically on their hypoglycemic indices are not indicated on the unit packs and also as part of food labels.
Hence, prolonged usage of such foods by the population at risk and the diabetics may aggravate health complications. Another drawback of the hitherto known diabetic formulations is that, most of them contain synthetic or non-nutritive sweeteners, and their prolonged usage may manifest in malignancy and may also lead to dysfunction of vital organs (Ralph G., Walton, Hudak R. and Ruth Green-Waite, Adverse reactions to Aspartame: Double blind challenge in patients from a vulnerable population. Biological Psychiatry, vol. 34, 13–17; 1993; Dennis Remington and Barbara Higa R. D., The bitter truth about artificial sweeteners. Aspartame Consumer Safety Network, Texas, 1987). Moreover, the formulations marketed as ‘foods for diabetics’ and not as hypoglycemic foods and hence, may cause an adverse socio-psychological effects on diabetics, and the population with impaired glucose tolerance or who are prone to diabetes may not use them.
Besides, many of them are herbal based products serving as source of phytochemicals and do not contribute carbohydrate energy and they may contain anti-nutrients and toxicants, which may cause health hazards to the consumer in the long run. To the best of our knowledge, no hypoglycemic food that is ready-to-eat or require minimum processing for consumption, that too in convenience form by the diabetics, especially in their workplace or during traveling, are marketed in the country. In view of this, there is a need to develop a process for preparation of hypoglycemic foods, suitable as total foods, food supplement and meal replacer for the Type II diabetics specifically, and which could also serve as normal diet for the healthy population. Hence, it was felt desirable to develop foods based on known and commonly available hypoglycemic food ingredients, and also containing protective as well as therapeutic nutrients such as dietary fiber, blood sugar regulators and micro-nutrients, suitably to provide as total nutritional support or as food supplement to diabetics and that too at price affordable by the needy, including consumers belonging to low income group.
TABLE 1Some of the diabetic foods marketed in IndiaResourceDiabetic'sZiprovit-Product nameDiabeticDiafoodNutrocal-DMD-ProteinspecialDCompanyNovartisSaga FoodWockhardtBritishYashaswiniMehcecnameConsumerProductsLife SciencesBiologicals,FoodLabs,Health IndiaPvt. Ltd.,Ltd, Lalru,BangaloreProducts,BangaloreLimited,ChennaiPunjabMysoreMumbaiMainHydrolyzedSprouted ragi,Maltodextrin,ProteinRagi, wheat,Dryingredientscorn starch,wheat, roastedwheyisolate,bengal gram,fruits,vegetable oil,bengal gram,protein,skimmedgreen grammilksodiumsoybean, greenvegetable oil,milk powder.and methisolids,caseinate,gram, blacksucrose,maltodextrin,predigesfructose,gram andcellulose, soymalt, cocatedcalciumfenugreekfiber, gumcerealscaseinate, soyacacia, soyextractfiber, soylecithinandprotein isolate,cocoacocoa powderpowderFormPowderPowderPowderPowderPowderPowderProtein (g%)26.8 (24%)12.0 (13.7%)  20 (16.9%)28.0 (86.2%)Not given30.0 (62.5%)Carbohydrates41.8 (37.4%)65.0 (74.3%)47.2 (3.1%)—Not given—(g%)Fat (g%)19.8 (40%) 3.0 (7.7%)22.6 (39.9%) 2.0 (13.8%)Not given 8.0 (37.5%)Fiber (g%) 5.414.0 6.4—Not given10.0Note:Values in parenthesis indicate the percentage energy derived from each of the nutrients